Saturday, October 10, 2009

What is Endometriosis?

“What is endometriosis?” is a common question since endometriosis occurs in roughly 10-15% of all reproductive age women.

Endometriosis is an abnormal condition that afflicts women, in which tissue that normally lines the cavity of the uterus (called endometrium) implants and develops in other areas of the body.

Endometriosis can cause pelvic pain, including but not limited to dysmenorrhea (painful and sometimes disabling pelvic or lower back pain during the menstrual flow), persistent pelvic pain (pelvic or lower back pain that occurs throughout the menstrual cycle), chronic pelvic pain (pain in the pelvis or low back that has persisted for over 6 months), dyspareunia (pelvic and lower back pain with sexual intercourse), dyschezia (painful bowel movements) or dysuria (discomfort with urination).

Endometriosis can also cause reduced fertility or infertility. All stages of endometriosis, from minimal endometriosis (stage I) to severe endometriosis (stage IV), cause a problem with becoming pregnant. Infertility caused by endometriosis is best treated with surgical removal (ablation) of the endometriosis implants. Medical management of endometriosis has been shown to be useful in controlling pain caused by this disorder but has not been shown to be useful in enhancing fertility.

Dr. Eric Daiter at The NJ Center for Fertility and Reproductive Medicine, LLC has extensive experience in the treatment of endometriosis and would be happy to help you. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. You can also visit us on the web at http://www.drericdaitermd.com/or http://www.ericdaiter.com/

Thursday, January 24, 2008

Pelvic Inflammatory Disease Requires Infertility Treatment

If you are a sexually active woman who has begun menstruating then you should know about pelvic inflammatory disease (PID). Educating yourself about this disease can help in prevent it or detect it in its early stages. This is a serious disease that can lead to life threatening illness if left untreated. It is estimated that 1 in 10 women will have PID, and 75% of the cases will occur in women under 25 years of age.

Pelvic inflammatory disease is an infection of the female reproductive organs. The infection is typically caused by harmful bacteria introduced to the vagina through unprotected sex with a person carrying STDs, such as Gonorrhoea or Chlamydia. Other causes of the infection may include an imbalance in the vagina’s normal bacteria or introduction into the uterus of harmful bacteria during medical procedures such as vaginal delivery, abortion, or dilation and curettage. Inflammation can occur in the uterus, fallopian tubes and in some cases the ovaries. If untreated, the infection can become quite severe and causing irreversible damage to the reproductive organs.

Inflammation from PID in the fallopian tubes often leads to infertility. It is the most common cause of ectopic pregnancy. This is when the fertilized egg is unable to make its way to the uterus and becomes lodged in the fallopian tubes. Ectopic pregnancy may be hard to detect as the symptoms experienced are similar to a normal pregnancy. Once the damage has been done, couples attempting to conceive will require infertility treatment, such as in vitro fertilization.

While actual symptoms vary among women, typical signs of PID are abdominal pain, pain during intercourse, and pain throughout the month similar to endometriosis symptoms. Other signs include malodorous (bad smelling) or unusual discharge from the vagina, burning pain while urinating, and unusual bleeding from the vagina. Some women will run periods of chills or high fever throughout the month combined with nausea and vomiting. Diagnosis of PID is usually determined when a patient suffers from the symptoms listed above and is confirmed by laboratory tests.

Typical treatment for pelvic inflammatory disease is a course of antibiotics taken by mouth, as well as medication for fever and pain. In severe and high risk cases, such as women who are pregnant, hospitalization is required for administration of intravenous antibiotics. It is recommended to abstain from sexual activity while completing the course of antibiotics. Although the bacteria that cause PID may be killed with antibiotics, there is no cure for this disease and it can be contracted again. Yearly pap smears can help with early detection. Prevention is best accomplished through monogamy, sex with only one partner as well as using condoms when sexually active. It is also critical to discuss sexual history, including STD’s, with your partner or partners.

If you are experiencing symptoms of PID, have had sex with someone you suspect may be carrying a sexually transmitted disease, or if you or your partner have multiple sexual relationships you should see your doctor immediately. Your life could depend on it.

Sunday, January 13, 2008

A Silent Epidemic

Billboards, television ads, and 7th grade health teachers all proclaim the message of safer sex, yet the U. S. Department of Health and Services estimates that 13 million people become infected with a sexually transmitted disease every year. According to the Center for Disease Control, Chlamydia is the most common sexually transmitted disease in the United States with 3 million new cases occurring each year. This article will talk about signs and symptoms of Chlamydia, how to treat it, and how to avoid it.

Chlamydia is caused by the bacterium Chlamydia trachomatis and is transmitted through vaginal, anal, or oral sex. It can also be transmitted to a new born baby as it passes through the birth canal of the infected mother. 50-75% of women infected with Chlamydia show no signs or symptoms and have no idea they are infected, which is why it is sometimes referred to as “the silent epidemic”. Chlamydia, when untreated, can cause pelvic inflammatory disease. This puts the woman at risk for infertility, endometriosis, and damage to the reproductive system. Endometriosis symptoms can be extremely painful, and if considering conception, may require infertility treatment. Common symptoms of Chlamydia include unusual vaginal bleeding or discharge, pain in the abdomen, fever, and painful urination. In order to diagnose Chlamydia a culture swab must be obtained

Once detected, Chlamydia can be cured with antibiotics. The most commonly used antibiotics in treatment of Chlamydia are Azithromycin, Doxycycline, Tetracycline, and Erythromycin. Antibiotics must be prescribed by a physician and are administered orally according to the doctor’s specifications. It is also important to complete your course of medication completely in order to recover from the infection. It may be a good idea to return to your doctor for Chlamydia testing every year, as it is possible to be re-infected with the disease even after treatment. Abstain from sex while being treated for the disease even if you no longer have symptoms. You can resume sexual activity once your course of antibiotics is finished.

The risk for transmission is dramatically reduced with the use of condoms with a water based lubricant, such as K Y Jelly. Petroleum based lubricants, such as Vaseline, should not be used because they break down latex (the material the condom is made of). The only sure way to avoid becoming infected with Chlamydia is abstinence (not having sex) or monogamy with an uninfected partner.

It is important for partners to discuss their sexual history before having sex and have STD tests done. Essential to prevention for sexually active individuals is an understanding of sexually transmitted diseases and how they are spread.

Monday, December 31, 2007

Female Infertility Factors

If you have had difficulty conceiving for more than twelve months, or six months if you are over 35 years of age, you may be wondering if you are infertile. Researchers estimate that one in six couples face fertility challenges as a result of male or female health complications. There are multitudes of factors that can affect your chances of conception. Here we will briefly outline three major causes of infertility in women: endometriosis, fallopian tube damage or blockage, and ovulation disorders.

Endometriosis occurs when uterine tissue shed during a woman’s “period” implants outside of the uterus. The implanted tissue responds to the hormonal cycle and continues to grow, shed, and bleed in sync with the lining of the uterus each month. This can lead to inflammation and eventually scarring which adversely affects functions of the ovaries, uterus, and fallopian tubes. Pelvic pain and infertility are common in women with endometriosis. Upon examination, more than 40% of infertile women of reproductive age are found to have endometriosis. Laparoscopic surgery to remove abnormal tissue is a commonly used treatment option for this condition.

Fallopian tube damage usually results from inflammation of the fallopian tube. This blocks the passage of the egg through the fallopian tubes on its way to fertilization and implantation in the uterus. Chlamydia, a sexually transmitted disease, is the most frequent cause. Tubal inflammation can cause pain and fever, or it may go unnoticed. Tubal damage is the major risk factor for ectopic pregnancy. Here a fertilized egg implants in the fallopian tubes. One episode of tubal infection may cause fertility difficulties. The risk of ectopic pregnancy increases with each occurrence of tubal infection.

Some cases of female infertility are caused by ovulation disorders. Disruption in the part of the brain that regulates ovulation can cause low levels of luteinizing hormone and follicle-stimulating hormone. Even slight irregularities in the hormone system can affect ovulation. Specific causes of hypothalamic-pituitary disorders include injury, tumors, excessive exercise and starvation. Ovulation-stimulating drugs, follicle-stimulating hormones, human chorionic gonadotrophin (HCG), and in vitro fertilization are possible treatments for this condition.

If you are one of the many couples experiencing problems with conception talk to your general practitioner. Most of these problems can be resolved with medical treatment or lifestyle adjustments. Your doctor will be able to diagnose any conditions present and give you treatment options, or refer you to a specialist.

The Pain of Endometriosis

Endometriosis is a condition where tissue found in the lining of the uterus attaches to organs and other areas outside the uterus.It is thought to occur in 10-20% of women between the ages of 20 and 45.While the cause of endometriosis is still unknown, there is a relationship between hormone estrogen and immune system dysfunctions.

During a women’s menstruation the lining of the uterus bleeds and sheds and is forced out of the uterus by small uterine contractions. Uterine tissue, called endometrium, that is shed makes its way into the pelvic cavity.This is referred to as retrograde menstruation.This displaced tissue may then implant on the ovaries, fallopian tubes, and on top of the uterus or its supporting ligaments.Other areas of occurrence are the abdomen, the area between the vagina and rectum, bowel, bladder, vagina, cervix, vulva, and in abdominal surgical scars. In rare circumstances they can be found in the lungs, arms, or thighs.

Women who suffer from endometriosis have been found to have excess levels of estrogen in their system.Studies have proposed that women with excessive levels of estrogen are at higher risk for endometriosis.This is because estrogen stimulates cell growth.Normally, the immune system is able to take care of any endometrial tissue that finds its way in to the pelvic cavity via retrograde menstruation.However, high levels of estrogen counteract the body’s ability to cope with the invading tissue.The immune system is overwhelmed and the implanted tissue grows and flourishes.This tissue will continue to respond to the hormonal cycle, and the shedding and bleeding causes inflammation and scarring.

One difficulty in diagnosing endometriosis is that the symptoms mimic several other medical conditions, such as ovarian cysts, pelvic inflammatory disease, ovarian cancer, colon cancer, fibroid tumors, or irritable bowel syndrome.The most common of endometriosis symptoms is pain. However, some women may experience no symptoms at all.Other symptoms include pain in the abdomen and lower back associated with the changes occurring during the menstrual cycle, pain experienced during intercourse, heavy or irregular periods, painful bowel movements and urination, diarrhoea or constipation, fatigue, and general chronic pain at any time.Additionally, endometriosis will cause infertility in 40% of women affected.

Treatment of endometriosis is the subject of some controversy, as the exact causes of the condition are unknown.Some treatments may focus on eliminating or reducing the amount of estrogen a woman’s body produces.Laparoscopy is a common infertility treatment when endometriosis affects a woman’s ability to become pregnant.Less obtrusive treatments suggest changes in diet and exercise routine, thereby strengthening the body’s muscles and immune system which help the body naturally fight the condition.

About Me

Name: Dr. Eric Daiter

Location: United States

Dr. Daiter graduated medical school at Temple University Medical School in Philadelphia and completed the Obstetrics and Gynecology residency program at Albert Einstein College of Medicine in New York. He completed his Reproductive Endocrinology and Infertility fellowship at the Hospital of the University of Pennsylvania. He has considered a career as a physician scientist in research medicine and has published several articles on molecular events that occur during the human embryo's implantation into the uterus.